Objective To investigate the diagnostic value and safety of medical thoracoscopy in unexplained exudative pleural effusion.Methods A retrospective analysis was conducted using the clinical data of 70 routine medical thoracoscopy examinations of unexplained exudative pleural effusion in patients.The lesions were examined pathologically under direct vision.Results White military nodules were observed under endoscopy,with multiple pro-truding nodules,focal irregular thickening of the pleura,pleural congestion,edema and adhesion.The diagnostic accu-racy of thoracoscopy was 95.7%.Among the diagnosed cases,there were 35 cases of tuberculous pleurisy,20 cases of malignant pleural effusion,8 cases of parapneumonic effusion,4 cases of pleural effusion from congestive heart failure and 3 cases of idiopathic pleural effusion,with no serious complications.Conclusion Medical thoracoscopy is a safe and accurate method in the diagnosis of unexplained exudative pleural effusion.Medical thoracoscopy is beneficial in the establishment of treatment method quickly and allows observation of the pleural lesions in pleural effusion patients using the naked eye.

Objectiye To reveal epidemiology of malignant tumor in Quanzhou area of Fujian province. Methods Medical record of adults who received health check-up between 2006 and 2010 was collected to estimate the incidence of malignant tumor. Chi-square test was used for data analyses.Results Nearly 12 323 individuals received an annual health check-up during 2006 and 2010,177 of whom were found to have malignant tumors. The identification rate of malignant tumors was 2. 87‰ per year, and the most commonly seen cancer included liver cancer ( 42. 93% ), lung cancer ( 20. 90% ), oesophageal cancer (9. 03% ), cervical cancer ( 8.47% ) and gastric cancer (6. 78% ). Those of 60 to 70 years old showed the highest incidence of cancer. Conclusion Annual health check-up may be helpful to identify early-stage malignant tumors.

Objective To observe the effects of Dong's Extraordinary Acupoints acupuncture and rehabilitation on upper limb spastic hemiplegia after stroke. Methods 105 patients with upper limb spastic hemiplegia after stroke were randomized into 3 groups as groups A, B, C equally, and receiving Baclofen and rehabilitation training, acupuncture at Dong's Extraordinary Acupoints, and both acupuncture at Dong's Extraordinary Acupoints and rehabilitation training for 8 weeks, respectively. They were assessed with China Stroke Scale (CSS) and modified Ashworth Scale (MAS) before and after treatment Results The CSS and MAS scores obviously improved after treatment in each group (P<0.01), and improved more in the group C than in the group A and B for CSS (P<0.05). Conclusion Both acupuncture at Dong's Extraordinary Acupoints and rehabilitation can improve the neural function and upper limb muscle tension in patients with upper limb spastic hemiplegia after stroke, with the synergistic effects.

Objective To investigate the prevalence of renal insufficiency and its associated factors in type 2 diabetes mellitus with normoalbuminuria using estimated glomerular filtration rate ( eGFR) .Methods We retrospectively analyzed 10-year data of chronic complications in type 2 diabetics in-patient from the Chinese Diabetes Society.eGFR was estimated using the equation from Modification of Diet in Renal Disease(MDRD) study.The clinical characteristics as well as associated factors for low eGFR were analyzed among the normoalbuminuric type 2 diabetic patients.Results A total of 1351 type 2 diabetic patients were included, 755 patients with normoalbuminuria, 466 patients with microalbuminuria and 130 patients with macroalbuminuria respectively.Among the patients, 310 (22.9% ) had low eGFR (GFR <60 ml · min~(-1) · 1.73 m~(-2) ) , 19.7% (149/755) in the patients with normoalbuminuria, 21.9% (102/466) in microalbuminuria and 45.4% ( 59/130 ) in macroalbuminuria Patients with normoalbuminuria and low eGFR suffered more chronic complications than those with normoalbuminuria and normal eGFR, mainly retinopathy, cerebrovascular diseases and sensory neuropathy.Stepwise logistic regression analysis revealed that age ( OR = 1.042, P < 0.001), diabetic duration ( OR = 1.038, P = 0.045), systolic blood pressure (OR = 1.017, P < 0.001) were independently associated with renal impairment among the patients with normoalbuminuria.Body mass index ( OR = 0.868, P < 0.001) and HbAlc (OR =0.898, P =0.021) were also related with renal insufficiency.Conclusion A considerable proportion in type 2 diabetic patients without albuminuria may exist renal impairment, and eGFR estimation could benefit the evaluation of renal function in such patients.

Objective We studied the clinical features and its significance of coal worker's pneumoconiosis combined with sleep apnea Methods In 40 patients with coal worker's pneumoconiosis combined with sleep apnea hospitalized from February 2006 to December 2009, polysomnography ( PSG) , blood routine, urine routine, blood pressure and biochemical indicators were measured and analyzed. Results Patients with coal worker' s pneumoconiosis combined with sleep apnea manifested mainly as duplicate hypoxemia and multi-organ dysfunction: high blood pressure, dysfunction of heart, lung and kidney, increase of serum glucose, blood lipids, blood uric acid and finally led a vicious cycle to aggravate the above mentioned damage. Conclusions In clinical, multiple-organ dysfunction resulted from severe hypoxemia and hypercapnia caused by coal worker's pneumoconiosis combined with sleep apnea, should be fully aware and give ational and effective treatment early to reverse or delay the further function damages of multiple organs, and therefore significantly improve the prognosis.

Objective To investigate the clinical results of posterior cruciate ligament (PCL) reconstruction by double bundle-double tunnel Y-shape of the anterior tibialis tendon allograft. Methods From March 2001 to January 2008, 47 patients underwent PCL reconstruction were included. The allogeneic adult anterior tibialis tendon was prepared into the Y-shape double bundles with the length of 130 mm; A bundle was defined as A-side; B-side was two short bundle (B1, B2 bundle). A bundle was 70 mm in length with a diameter of 10-12 mm. B1 bundle (anterolateral bundle) was 55 mm long with a diameter of 6 mm; B2 bundle(posteromedial bundle) was about 50 mm with a diameter of 6 mm. The allograft ligament was installed through the antero-medial approach. Absorbable interface screws were fixed in the tibial tunnel firstly, and then in the femoral tundles. When being fixed, anterolateral bundle was in flexion of 90°, postero-medial bundle was in 30°. Assisted exercise with knee an angle-locked walking aid had continued for 8-10 weeks. Results The average operating time were 45 min. The average follow-up time was 49.5 months. Preoperative Lachmann was positive in all cases while Lachmann was negative in 39 cases, weakly positive in 5 cases, and positive in 4 cases postoperatively. Post-operative KT-1000 testing, Lysholm score and Tegner activity levels has improved significantly compare with the pre-operative ones. Conclusion The double folded bundles of adult anterior tibialis tendon has sufficient length and diameter for posterior cruciate ligament reconstruction with power tension. The methods of ligament passing through the tunnel has improved to ease the procedure.

Objective:To construct a recombinant eukaryotic expression vector containing gene encoding 18 000 outer membrane protein from human Helicobacter pylori(H.pylori) and be expressed in COS-7 cell,and lay the foundation for the exploiting DNA vaccine of Hp.Methods:The target genes encoding 18 000 outer membrane protein were acquired from the prokaryotic expression vector pET32a(+)/528 by XholⅠ,KpnⅠ digestion simultaneously,in the same way,the pcDNA3.1 was digested by XhoⅠ,KpnⅠ digestion simultaneously,and the objective genes and pcDNA3.1 were extracted out of agarose electrophoresis with gel kit,and connected by T4 ligase.The recombinant vector pcDNA3.1/528 was used to select and transform,meanwhile express in COS-7 cell.The expressions of recombinant eukaryotic vector in COS-7 cell were investigated by reverse transcriptive-polymerase chain reaction and Western.Results:The gene had inserted into eukaryotic vector was the target gene encoding 18 000 outer membrane protein by enzyme digestion analysis,and objective gene was amplified from COS-7 cell transfected with pcDNA3.1/528 by RT-PCR,the Western showed that recombinant eukaryotic vector could be expressed in COS-7 cell.Conclusion:The recombinant eukaryotic vector pcDNA3.1/528 was constructed and expressed in COS-7 cell successfully.The results obtained lay the foundation for research on development of H.pylori DNA vaccine.

Objective To analyze the influence of radial neck fracture on the upper limb function in older children,and to evaluate the curative effect of plate fixation in the treatment of Salter-Harris Ⅱ type of radial neck fracture.Methods The clinical data of 16 older children with radial neck fractures who treated by T plate internal fixation were retrospectively analyzed.16 cases were closed fractures,merging radial nerve injury in 1 case,3 cases of distal humerus fractures,1 case with rib fractures,fractures were Salter-Harris Ⅱ type,adopt steel plate internal fixa tion.Results 1 6 patients were followed up for 9-1 8 months.X-ray healing time was 6-9 weekson average 7.6 weeks.No malunion and no healing,no case of epiphyseal injuries.1 patient appeared steel block forearm supination.Postoperative patients with forearm pronation were greater than 90° supination were greater than 60 °.No radial nerve injury.Evaluation results were good.Conclusion Clinical treatment effect of open reduction and plate internal fixation in the treatment of older children with Salter-Harris Ⅱ type of radial neck fracture is satisfactory.Surgical treatment not only can enhance the fracture stability,but also can do the elbow joint function exercise to prevent dysfunction much earlier.

Objective To analyze recent 30 years’ regularities in point selection for acupuncture treatment of Parkinson disease and provide reference for its treatment. Methods Parkinson disease, parkinsonism and acupuncture were used as key words. Recent 30 years’ Chinese literature was searched using Wanfang, CNKI, VIP and Chinese biomedical literature database. Selection of main acupoints and scalp acupuncture points, syndrome differentiation-based point selection and meridian tropism of main acupoints were metrologically studied. Results The Du meridian, the large intestine meridian and the gallbladder meridian were mainly selected for acupuncture treatment of Parkinson disease. Taichong(LR3), Baihui(GV20), Hegu(LI4) and Fengchi(GB20) were used as main points. Chorea-tremor control area, motor area and parietotemporal anterior oblique line were often selected as main scalp acupuncture points. Fenglong (ST40), Qihai(CV6), Sanyinjiao(SP6), Yinlingquan(SP9) and Zusanli(ST36) were often used according to syndrome differentiation-based point selection. Conclusion Modern acupuncture doctors select Taichong(LR3), Baihui(GV20), Hegu(LI4) and Fengchi(GB20) as main points, often use scalp acupuncture points and combine points mainly from the Du meridian according to syndrome differentiation in the treatment of Parkinson disease.

Colorectal cancer( CRC) has become one of the major cancer threatening residents′health all around the world, and considerable resources are needed for its prevention and control.Economics evaluation could provide the basis of decision-making for improving the allocation efficiency of health resources in the field of CRC prevention and control.This paper comprehensively reviewed the papers that have been published in the field of colorectal cancer screening,from the points of view of published time,regional economic evaluation re-search,evaluation method,the research angle,input and output measurement,model,recommend strategy.